<!-- INCLUDE overall_header.html -->

<form method="post" action="{U_ACTION}" id="register">
<div class="panel">
	<div class="inner"><span class="corners-top"><span></span></span>
			<h2>{SITENAME} - {L_PERSO_CHECK}</h2>
			
	<fieldset class="fields2">
		<!-- IF ERROR --><dl><dd class="error">{L_PERSO_ERROR}</dd></dl><!-- ENDIF -->
		<dl>
			<dt>
				<label>{L_PERSO}:</label><br /><span>{L_PERSO_EXPLAIN}</span>
			</dt>
			<dd>
				<input type="text" name="part1" maxlength="11" size="11"> << 
				<input type="text" name="part2" maxlength="7" size="7"> <
				<input type="text" name="part3" maxlength="7" size="7"> <<<<<<<
				<input type="text" name="part4" maxlength="1" size="1">
			</dd>
		</dl>
	</fieldset>
	<span class="corners-bottom"><span></span></span></div>
</div>

<div class="panel">
	<div class="inner"><span class="corners-top"><span></span></span>

	<fieldset class="submit-buttons">
		{S_HIDDEN_FIELDS}
		<input type="reset" value="{L_RESET}" name="reset" class="button2" />&nbsp;
		<input type="submit" name="submit" id ="submit" value="{L_SUBMIT}" class="button1" />
	</fieldset>

	<span class="corners-bottom"><span></span></span></div>
	</div>

</form>

<!-- INCLUDE overall_footer.html -->